Clinical Tips

SBP drop >40 mmHg sustained → Lower patient immediately, notify physician Any symptoms + BP drop → Lower patient, do no

Initial OH 10-20 seconds Usually benign, resolves quickly. Often causes brief dizziness on standing. Classic OH 30 sec

Meds: lisinopril + furosemide + tamsulosin triple OH risk Baseline 5min supine: 142/84, HR 72 1-min standing: 126/78,

Symptomatic OH carries a HIGHER fall risk than asymptomatic OH, even with a smaller BP drop. Ask "Do you feel dizzy or

Prioritize orthostatic assessment for: • Age >65 prevalence up to 30% • Multiple BP medications additive hypotensive ef

F — Fatal: Lactate >4 mmol/L ~50% mortality, rising trend despite resuscitation A — Assess: Measure within 1 hour, tren

That's a coin flip between life and death. Your weapon: trend lactate every 2 hours. If it's not clearing by 20%, esca

| Level | Risk | Action | |-------|------|--------| | <2 mmol/L | Normal | Monitor if sepsis suspected | | 2-4 mmol/L |

Memorize these 3 numbers for lactate monitoring: 1️⃣ 2 mmol/L = Red flag threshold 2️⃣ 4 hours max between repeat lact

Reality: One lactate tells severity. The trend tells survival. A single value is a snapshot. Serial measurements ever

Normal lactate ≠ stable patient. Some patients have tissue hypoperfusion with normal lactate. Look for: • Capillary re

Lactate going UP during resuscitation = treatment failure. Immediate actions: • Reassess source control • Evaluate flu